CC-0728-2023 - TOWN OF QUEENSBURY
742 Bay Road,Queensbury,NY 12804-5904 (518)761-8201
Community Development-Building& Codes (518) 761-8256
Building Permit No. CC-0728-2023
Property Location: 170 LUZERNE RD
Property Owner: Carlino Management LLC
Approved for the following uses: Non-loadbearing wall to separate room & create reception
area
Conditions of approval:
1) Complete front parking area asphalt paving and ramp to front entrance door. 2) Install handicap
parking and no parking sign in designated area. 3)Install handicap parking and parking lot striping.
4) Complete all site work for front parking lot.
90 Day Temporary CO expires on: 07/08/2024
*A final inspection for this project must be scheduled before the expiration of this
Temporary Certificate of Occupancy - if your project is not complete within this
90 day period you will be subject to additional fees*
Print Name: Nick Carlino
Signature of Applicant:
Director of Building & Codes:
Town of Queensbury Building&Codes Office
Dept. of Community Development 742 Bay Road,Queensbury,NY
r 7014 Office Use Only
1
ADDITION ALTERATION PERMIT Zs( -2_67
g /� � Permit#: �� �� 3
Tosco of Queeneenry A I CA it O N
Permit Fee:$ Z UD- 00
742 Bay Road,Queensbury,NY 12804 J Li
P:518-761-8256 www.queensbury.net ®V 'I2o213 Invoice#:
Flood Zone? Y N Reviewed !
LJ2R
��L ri 4 k
Project Location: 170 (-u Ze rnr Rcedl Queei-S L,rc'
Y
Tax Map ID #: 3 U y • 1-2- Subdivision Name:
PROJECT INFORMATION:
TYPE: ❑ Residential .commercial, Proposed Use:fpo„N•.g. c
❑ Single-Family ❑ Two-Family ❑ Multi-Family (#of units_) ❑ Townhouse
usiness Office ❑ Retail Industrial/Warehouse ❑ Garage (#of cars
❑ Other (describe
ADDITION SQUARE FOOTAGE: ALTERATION SQUARE FOOTAGE:
1st floor: 1st floor:
2nd floor: 2nd floor:
3rd floor: 3rd floor:
Basement (habitable space): Basement (habitable space):
Total sq ft: Total sq ft:
Scope of work to be done: f 1.,roal I R•P 'hO GA 1 G,•. L.J-c.r I
(V1 ci n c c1 -/-o Sri I J- f c - i t o 1 O Sic 'l—tc.— )
n- 1rC2 �rjI "li.e 2 Xcil G--�_ Ckee r-cfr L I( f
Tke_ c- I 1-/-41 I"3-Q' Cet
Addition/Alteration Application Revised June 2022
ADDITIONAL PROJECT INFORMATION:
1. Estimated Cost of Construction: $ 300 r,
2. Source of Heat (circle one): Gas ❑ Oil ❑ Propane ❑ Solar El Other: •
Fireplaces/inserts need a separate Fuel Burning Appliances & Chimney Application
3. Are there any structures not shown on the plot plan? El YES ❑ NO Explain:
4. Are there any easements on the property? ❑ YES ❑ NO
SITE INFORMATION:
• Is this a corner lot? ❑ YES O
• Will the grade be changed as a result of the construction? ❑ YES ( O
• What is the water source? I2uBLIC ❑ PRIVATE WELL
• What type of wastewater system is on the parcel? ❑ SEWER 7RIVATE SEPTIC
DECLARATION:
1. I acknowledge that no construction shall be commenced prior to the issuance of a valid permit and will be
completed within a 12 month period.Any changes to the approved plans prior to/during construction will require
the submittal of amended plans,additional reviews and re-approval.
2. If,for any reason,the building permit application is withdrawn, 30%of the fee is retained by the Town of
Queensbury.After 1 year from the initial application date, 100%of the fee is retained.
3. If the work is not completed by the 1 year expiration date the permit may be renewed, subject to fees
and department approval.
4. I certify that the application, plans and supporting materials are a true and a complete statement and/or description
of the work proposed, that all work will be performed in accordance with the NYS Building Codes, local building laws
and ordinances, and in conformance with local zoning regulations.
5. I acknowledge that prior to occupying the facilities proposed I, or my agents, will obtain a certificate of
occupancy.
6. I also understand that I/we are required to provide an as-built survey by a licensed land surveyor of all newly
constructed facilities prior to issuance of a certificate of occupancy.
I have read and agree to the above:
PRINT NAME: /
SIGNATURE: DATE: I 6 f—�
/
Addition/Alteration Application Revised June 2022
•
e
CONTACT INFORMATION: PLEASE PRINT LEGIBLY OR TYPE, PLEASE INCLUDE AN EMAIL
• Applicant:
Name(s): NicJC O crITnu
Mailing Address, C/S/Z: $ �} Wej�. bQrry LK)c- t C2,ee-1114, ' .N y 1946
Cell Phone: ( I c ) 7 1 " 070 Land Line: (
Email: Pt c4 -11tiv ) 763Sty I -wr^
• Primary Owner(s):
Name(s): i s
Mailing Address, C/S/Z:
Cell Phone: ( ) Land Line: ( )
Email:
Check if all work will be performed by property owner only
• Contractor(s): (List all additional contractors on the back of this form)
Contact Name(s):
Contractor Trade:
Mailing Address, C/S/Z:
Cell Phone: ( ) Land Line: ( )
Email:
**Workers' Comp documentation must be submitted with this application**
• Architect(s)/Engineer(s):
Business Name:
Contact Name(s):
Mailing Address, C/S/Z:
Cell Phone: ( ) Land Line: (
Email:
Contact Person for Compliance in regards to this project: ! C of I'"�
Cell Phone: ( S I Y ) 7? 1 ' `{i 7 6 Land Line: ( )
Email: (1 G c-4-1 t^c, 17 D N-c I , �c
Addition/Alteration Application Revised June 2022
FIRE MARSHAL'S OFFICE
Queensbury
f� � - - -- Town of Q J
742 Bay Road, Queensbury, NY 12804
"Home of Natural Beauty ... A Good Place to Live "
PLAN REVIEW
Carlino Management LLC
170 Luzerne Rd
CC-0728-2023
11/17/23
I have reviewed the submitted drawings for the above project; and offer the
following comments:
1) Verify Fire extinguisher locations & inspection.
2) Locks / latches shall comply with 2020 NYSFC.
3) Verify operation of existing exit/ emergency lights. If not in place, will
require installation. Add Combo light inside new wall leading out to
waiting area
4) Verify CO Detection
5) Verify Aisles
6) Knox Box required.
7) All Electrical covers in place and panel Labeled
Deputy Fire Marshal
Tyson Converse
742 Bay Road
Queensbury NY 12804
518 761 8205
tysonc@queensbury.net
Fire Marshal 's Office • Phone: 518-761-8206 • F a x: 518-745-4437
firemarshal@queensbunj.net www.queensbury.net